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Health Insurance Exchanges and the Long Road Ahead


With less than two years before health insurance exchanges are to become operational, many questions and concerns remain.

With less than two years before health insurance exchanges are to become operational, many questions and concerns remain. For instance, how will states set up this online forum for consumers to buy subsidized private insurance? How will they be operated? Who will fund them? And what governing body will be responsible for monitoring them?

Questions like these are causing many states to take a wait-and-see approach. After all, the Supreme Court still has yet to hear the oral arguments for various provisions of the Patient Protection and Affordable Care Act (PPACA). And with November elections results already looming, many wonder whether or not there will be any significant changes to the legislation. Add to these concerns the accessibility to sophisticated technology; some states are being hindered by systems that are not yet equipped to perform all of the necessary tasks that will need to be part of a successful health insurance exchange.

Despite a number of states that are considered to be moving at a “brisk pace” to create their health insurance exchanges (California, Connecticut, Maryland, Oregon, Rhode Island, Vermont, New York, New Jersey and Washington), many states are opting to give the appearance of progress without doing much at all. For instance, states like Missouri, Arkansas, and Georgia are “investigating” their options. Other states, such as Wisconsin, Florida, and Louisiana have simply rejected the idea of setting up an exchange and opted to return the federal funding they initially received. Of course, the White House doesn’t want the public to believe that progress has been limited. In their “2012 Progress Report: States Are Implementing Health Reform” report, we are told that “28 States and the District of Columbia are on their way toward establishing their own Affordable Insurance Exchange.”

Regardless of which individual states are making (or not making) progress, many decisions that have yet to be made that will impact the way in which health insurance exchanges are implemented. It’s hard to fault states that are reluctant to invest large amounts of time and resources at this time based on those concerns. However, by the same token, it is necessary to have some states grab the bull by the horns and begin this process. Their experiences and protocols will help determine the pitfalls and best practices for setting up a successful health insurance exchange. And while they will be susceptible to changes to legislation and other risks, they will also yield the greater reward by being well ahead of the curve come deadline time and will not have to scramble to catch up.

Around the Web

Many States Take a Wait-and-See Approach on New Insurance Exchanges [New York Times]

The Status of Health Insurance Exchanges [The Health Care Blog]

2012 Progress Report: States Are Implementing Health Reform [WhiteHouse.gov]

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